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NOTE: PULL ALL -_ :RMITS (Septic, Well, etc.) MAKE _APIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: ��,1/.! Connection Necessary ? [] Yes JE] No <br /> Does Existing Septic System comply with San Joaquin County Development Title ? Yes No Unknown <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well? .© Yes No Is well properly sealed and constructed ? ®Yes F] No <br /> Describe deficiency, if any: .y Q::, <br /> Is well system a Public Water system ? E] Yes No Is Public Water System Permit current? Yes No <br /> Does existing or proposed use make this a Public System ? F-1 Yes ❑ No <br /> Is water/well sampling current ? ❑ Yes No <br /> Additional information or comments: <br /> 3. GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? El Yes El Ido Service Area No. <br /> Other proposed disposal method: <br /> PotentialProblem(s): !.yn�.� <br /> 4. FLY, MOSQUITO OR VECTOR CONTROL: / <br /> Describe potential Vector Control issues: <br /> 5. TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: -wr <br /> Additional facilities required: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> List any problem(s) not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: -,. �r�.1/ <br /> EH 06 06 Report#7201 March 07,2006 <br />